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Information for healthcare professionals in Sweden only.

Do epinephrine auto-injectors have an unsuitable needle length in children and adolescents at risk for anaphylaxis from food allergy?

Study by S. Dreborg, X. Wen, L. Kim, G. Tsai, I. Nevis, R. Potts, J. Chiu, A. Dominic and H. Kim. In Allergy, Asthma & Clinical Immunology 2016 12:11.


Food allergy is the most common cause of anaphylaxis in children. Intramuscular delivery of epinephrine auto-injectors (EAI) is the standard of care for the treatment of anaphylaxis.

The researchers examined if children and adolescents at risk of anaphylaxis weighing 15–30 kg and >30 kg would receive epinephrine into the intramuscular space with the currently available epinephrine auto-injectors in North America and Europe.


The distance from skin to muscle (STMD) and skin to bone (STBD) on the mid third anterolateral area of the right thigh was measured by ultrasound applying either high pressure (max) or slight pressure (min) in:


Group 1, 15-30 kg:

Group 2, more than 30 kg:


There is a risk of intraosseous injection using high pressure EAI (Epipen®/Epipen Jr®, Auvi-Q®/Allerject® and especially Jext®) in children at risk of anaphylaxis.

There was also a risk of subcutaneous injection using the currently available high pressure EAI in children and adolescents.

Read the full study in Allergy, Asthma & Clinical Immunology Journal

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